| NPI | 1306230859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 064981) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 287151) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2020-06-23 |